Understanding the experience of transactional sex among young women in Winnipeg and its implications for health policy By Dianne Cheng A Thesis Submitted to the Faculty of Graduate Studies of The University of Manitoba In Partial Fulfillment of the Requirements For the Degree of Masters of Science Family Social Sciences University of Manitoba Winnipeg, Manitoba Copyright © 2013 by Dianne Cheng UNDERSTANDING THE EXPERIENCE 2 Acknowledgements I wish to thank the following people for their knowledge, guidance, and support in the development and completion of this thesis: The young women who allowed me to interact with them one-on-one and shared a part of their lives by telling me their stories. Without them this research would have been impossible The staff at various agencies servicing young women who so kindly and willingly helped to recruit young women My thesis committee including Dr. Javier Mignone, Dr. Kerstin Roger, Dr. Susan Frohlick, and Paula Migliardi for sharing their knowledge and insight. They gave their time and encouraged me throughout this process My friends and family for standing by me and supporting me throughout the past year UNDERSTANDING THE EXPERIENCE 3 Abstract While there is evidence that young women involved in transactional sex face economical, emotional and health disadvantages, few studies have examined young women’s understanding and knowledge of risky behaviours (e.g., substance abuse, acquiring sexually transmitted infections including HIV/AIDS, domestic violence, etc.) and how these influence their health and well-being. The debate on the definitions, relevance, and causes of transactional sex, as well as on the approaches to address it, is ongoing. There is considerable agreement that sexual exchange needs to be addressed from a variety of contexts to obtain a comprehensive picture of how women understand their experience. This qualitative study used phenomenological techniques (interviews, questionnaires, focus groups, observation, and field notes) to collect data and conduct analysis on 15 young women between the ages of 18 and 27. The focus of the study was to explore issues of health and social services as identified by young women involved in transactional sex. This study enabled them to discuss the struggles they encounter (such as issues related to housing, addictions, employment opportunities, and skills level). Findings from the study identified issues that may help to develop programs and policies to provide better supports to young women involved in transactional sex. UNDERSTANDING THE EXPERIENCE 4 Table of Contents Acknowledgements………………………………………………………………………………..2 Abstract……………………………………………………………………………………………3 Chapter One: Introduction and Statement of the Problem and Purpose……………………..........6 Chapter Two: Literature Review Differentiating Sexual Exploitation and Transactional Sex……………………………...10 Transactional Sex in Canada……………………………………………………………..12 Impact of Transactional Sex on Health…………………………………………….…….13 Gender and Health Outcomes Related to Transactional Sex……………………….…....14 Lack of Awareness, Recognition and Understanding of Transactional Sex of Youths…………………....................................................................................................16 Transactional Sex and Mental Health…………………………………………………....17 Impact of Perception and Risky Behaviour……………………………………………...18 Gaps in Service Provision…………………………………………………………….….20 Theoretical Perspective for the Present Study……………………………………….......22 Figure 1. Young Women Engaging in Transactional Sex and Their Environment………………………………………………………………………….......23 Chapter Three: Methodology The Philosophical Basis of Hermeneutic Phenomenology Research…………………...26 The Researcher’s Role…………………………………………………………..............27 Criteria for Sample Selection……………………………………………………………30 Participants………………………………………………………………………………31 Sample Recruitment……………………………………………………………..............31 Interviews and Focus Groups…………………………………………………………....34 Data Analysis……………………………………………………………………………35 Ethical Consideration……………………………………………………………………36 Chapter Four: Background History and Context……………………………………….………..38 Women’s Lives and Context……………………………………………………………..47 Reasons for Exiting Transactional Sex ………………………………………………….65 Beliefs and Attitudes of Women Involved in Transactional Sex………………………..67 UNDERSTANDING THE EXPERIENCE 5 Health Setbacks ………………………………………………………………………....69 Sexually transmitted infections………………………………………………….76 Drug and alcohol use and transactional sex…………………………………......81 Pregnancy………………………………………………………………………..85 Intensity of violence……………………………………………………………..86 Strategies to limit violent interactions…………………………………………...91 Sexual intimacy and relationships……………………………………………….92 Sexual intimacy……………………………………………………….....92 Relationships: sexual arrangements……………………………………101 Condom Use…………………………………………………………………………....110 Control………………………………………………………………………………….111 Women Oppressing Women………………………………………………………........114 Child and Family Services……………………………………………………………...117 Service Needs…………………………………………………………………………...119 Chapter Five: Discussion…………………………………………………………………….…126 Limitations……………………………………………………………………………...148 Chapter Six: Conclusion and Implications……………………………………………………..149 References………………………………………………………………………….…………...153 Appendix A…………………………………………………………………………….……….163 Appendix B……………………………………………………………………………….….…165 Appendix C……………………………………………………………………………….…….168 UNDERSTANDING THE EXPERIENCE 6 Chapter One: Introduction and Statement of the Problem and Purpose Sexually transmitted infections (STIs), including Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS), are serious health risks in the lives of women involved in transactional sex, especially those who also have coinciding mental health issues. The goal of the study is to understand the needs of the young women who have experienced transactional sex in order to better assist in the development of appropriate health and social programs and policy. Sexual exploitation is a term widely accepted by professional society in labelling and interpreting young women’s actions when engaging in sexual interaction for the exchange of goods and services. Young women, however, do not necessarily associate themselves with being sexually exploited. Although the young women reported risks with transactional sex (rape, physical assaults and death) they felt the transactional sex empowered them to supplement their income for purchasing material goods (cell phones, clothing and drugs). The women felt that they made the choices to engage in sex for money and that they were not necessarily victims. Instead the young women felt the transactional sex was a trade to be exchange when, where and how they wanted when there was a need. Some of the women identified themselves as being independent and the transactional sex increased their status among their peers through the material goods they had. In cases where cash payments are made to women engaging in sexual exchange, this is usually described by professional society as prostitution or commercial sex. However, when the exchange is not a straight monetary transaction, particularly when it is not practiced on a professional level, the term survival sex is used (Muir, 1991). Muir (1991) indicates the latter term is often associated with the women’s poverty and dependency on men. The term transactional sex suggests that not all forms of sexual exchange are carried out to achieve profit or survival (Lelerc-Madlala, 2003). Rueben (2011) defined transactional sex work UNDERSTANDING THE EXPERIENCE 7 as the exchange of money, goods, gifts, or drugs for sexual services that occurs in a wide range of relationships and sexual encounters in diverse environments. To bridge the gap between the viewpoints of professionals and these young women, terms such as transactional sex, sex work, and sexual exchange will be used interchangeably throughout this paper to describe the women’s experience. The relationships, interactions, and choices of these young women are complex, and their lived experiences will affect the understanding of their circumstances. Transactional sex incorporates other reasons why young women exploit their bodies, including positive and empowering terms. This study focused on women aged 18 to 27 years old who have been involved in transactional sex at one point in their lives. Although there are common issues to both female youths and female adults, there are significant differences regarding policy and laws that are relevant to each population. The explanation of the difference between female youths and female adults will be presented in Chapter Three. McIntyre (2002) found that 43% of the police, judges, social workers, politicians, teachers, and municipal government officials who completed the survey did not feel any responsibility for the younger, vulnerable population of youths. The findings from this study are intended to raise awareness among the professional community and society about the particular experience of this female youth population who have been involved in transactional sex. Women involved in transactional sex are faced with a wide range of problems including poor health, violence, poverty, and unfair treatment in the criminal justice system (Stout & Kipling, 1998). There are several gaps and barriers to providing health services and programs to this population as these young women are prevented from participating in making decisions about their own welfare when service providers and government